小剂量激素合并霉酚酸酯治疗狼疮性肾炎

Combined treatment of small dose corticosteroids and mycophenolate mofetil for lupus nephritis

目的 观察小剂量激素合并霉酚酸酯 (MMF)治疗狼疮性肾炎 (LN)的疗效及不良反应。方法 32例不同病理类型的LN患者中 ,有 2 9例治疗前进行肾穿刺活检。给予小剂量激素 (泼尼松 <0 .5mg·kg-1·d-1)合并MMF(1.5 g/d)治疗 ,持续 6个月 ,观察疗效及不良反应。结果 本组治疗的总有效率为 6 2 .5 %。各病理类型中有效的病例数分别为 :Ⅲ型LN 2 /2例 ,Ⅳ型LN 13/2 1例 ,Ⅴ型LN 4 /6例 ;未作肾穿刺活检组为 3/3例。 7例次 (2 1.8% )发生不良反应。

Objective To observe the efficacy and adverse effects of small dose corticosteroids plus mycophenolate mofetil (MMF) on lupus nephritis (LN). Methods 32 cases of LN were studied, among which 29 received renal biopsy prior to treatment. All patients were given small dose corticosteroids (prednisone<0.5 mg·kg -1 ·d -1 ) and MMF(1.5 g/d) persisting for 6 months. Results The general effective rate of the regimen was 62.5%. Various degree of effectiveness could be observed in each groups as 2/2 in type Ⅲ LN; 13/21 in type Ⅳ LN; 4/6 in type Ⅴ LN and 3/3 in non biopsied. Adverse effects occurred in 7 cases (21.8%). Conclusion Combined treatment of small dose corticosteroids and mycophenoplate mofetil is efficacious for lupus nephritis.